A Journal of Medicine and Surgery, published every other Saturday. Price $3.00 a year, postage paid. This journal is devoted solely to the advancement of medteal science and the promotion of the interests of the whole profession. Essays, reports of cases, and correspondence upon subjects of professional interest are solicited. The editors are not responsible for the views of contributors. Books for review, and all communications relating to the columns of the journal, should be addressed to the EDITORS OF THE AMERICAN PRACTITIONER and NEWS. Louisville, Ky. Subscriptions and advertisements received, specimen copies and bound volumes for sale by the undersigned, to whom remittances may be sent by postal money order, bank check, or registered letter. Address JOHN P. MORTON & CO. 440 to 446 West Main Street, Louisville, Ky. MEDICAL ASPECTS OF THE TORNADO. As every body knows by this time, the city of Louisville was visited, on the night of March 27th, by what is probably the most destructive tornado on record. A path nearly two miles long and about one fifth of a mile in width was cut diagonally through a thickly populated portion of the city, with a destruction of property that must be seen to be realized. But great as this destruction of property was, it is less remarkable than the light list of casualties incident upon the storm. If the horrors of Falls City Hall, where some two hundred people had assembled for lodge meetings and a dance, and the casualties at Main Street, between Seventh and Eighth, where a building containing a saloon, a cigar store, and sleeping apartments for the servants of a hotel, went to the ground, could be eliminated, the list of deaths and injuries would have been no greater than is often reported after a similar sweep of a tornado through a country town. Of course this was largely due to the hour of the day when the storm broke upon the city. At 8:30 o'clock in the evening the schools, the factories, the warehouses, and the business houses were deserted, and many casualties were thus averted; but the four or five hundred dwellings that went down contained the wonted number of occupants, and it is simply marvelous that the death list among these should not have exceeded eight or ten. This low list of casualties is doubtless due to the fact that under the force of the wind the houses as a rule exploded, the walls falling almost invariably outward. At the two places above named, where buildings went down upon many occupants, the damage done to life and limb was appalling, and from the list, as presented by the coroner, some facts of surgical interest may be gleaned. The total number of deaths was seventy-five, and of the wounded two hundred and fifty. In the case of the former, death was caused by injuries which in the order of frequency may be thus arranged: 1. Crushing of the thorax, with injury of the heart and lungs. 2. Fracture of the skull, with injury of the brain. 3. Suffocation. 4. Compound and comminuted fractures of the extremities, with resulting hemorrhage. 5. Shock. 6. A few were burned to death. Another remarkable feature of the disaster is that two only of the injured have since died. This, in view of the great number of compound fractures sustained by the sufferers, is a noteworthy fact, and bears conclusive testimony to the efficiency of antiseptic surgery. No medical institutions were in the track of the storm. The morgues were well filled, but the hospitals were in no case overcrowded, since few of the people injured were without homes situated out of the fatal track, where they were carried and received the needed attention. It need not be stated that, as soon as the knowledge of the calamity came to their ears, physicians in large numbers went to the points where their services were needed, where they were untiring in their ministrations to the sufferers, some of them remaining at the scene of greatest destruction of life and limb, without rest and without refreshment, for from twenty-four to forty-eight hours. We say that this need not be recorded, because the physician is always and everywhere, in the time of public calamity, foremost among the helpers a work which he does always from a sense of duty without thought of emolument, and for which he is entitled to no especial praise. One other feature of the storm remains to be noted. For some hours preceding the tornado the barometer showed the lowest reading ever recorded by the signal service in this district. In consequence of this, many of the sick, the delicate, and the overworked complained of undue depression, for which malaria in not a few instances got undue credit. Notes and Queries. THE BRITISH MEDICAL JOURNAL of March 8th publishes a picture of the home of Ephraim McDowell, the place where the first ovariotomy was done, with the following quotation from a lecture by Sir Spencer Wells, who some years since paid this graceful tribute to the memory of the father of ovariotomy: "McDowell was wise, practical, and prophetic. He carefully studied the subject which filled his mind, did with an enviable success what his opportunities permitted, and looked with an anxious eye on the prospect opening up to his successors. We, more happy in our opportunities, have entered into full possession of what to him was little more than a promised land; and, speaking personally, I feel it my greatest happiness to have been able, chiefly through the encouragement of professional brethren (which at one time I had little reason to anticipate), to reach the point at which McDowell aimed. I have not only obtained the amount of operative success which he gave as the standard; I have not only the almost daily gratification of seeing some living and enduring evidences that my labors have not been in vain; but I have for the rest of my days the satisfaction of knowing that my example has emboldened others, and will be the means of still further extending to human suffering the consolatory assurance of the prospect of relief, and insuring the certainty of its realization by the many skillful hands which are now betaking themselves to the work. This is a lot which falls to but few in novators. It is not given to every one to see the fruit of his labors; but the surest way of gaining that end is by studying the words and following the counsels of wisdom. The wish to do well what others have done is not all that is wanted. Step by step their course must be followed, difficult still, but somewhat easier from the result of experience; and while I content myself with a warning to aspirants that a fancied inspiration will not alone carry them on to success, I feel I can not quit them and the subject better than by repeating the words of McDowell, who, though better known in the open rugged field of practice than in the paths of literature, was a man of broad and elevated views, and thus expressed the advanced opinions he had already formed respecting the operation he had inaugurated after years of patient waiting and zealous preparation. He strove to make ovariotomy a boon to humanity. He had reason to believe it had proved so, but he foresaw the dangers of its abuse from rash and indiscriminate rivalry among his followers." We have reproduced this eulogy upon McDowell because we are now able to present our readers with a drawing of his Kentucky home, which was forwarded with an interesting letter to Sir Spencer Wells by Dr. Dunlap, of Danville, Kentucky. Dr. Dunlap writes: "I take pleasure in sending you by this post a photograph, which I am sure you will, above all men in the world, enjoying owning. It is the home where Ephraim McDowell lived for many years, and the small brick room in the foreground and to the left of the large building is the one in which the first ovariotomy was performed. The small room to the right, just beyond the man leaning on the cane, was the consulting room and office of Dr. McDowell. Time has wrought many changes, and the home is now in the possession of the lowest class of negroes, our former slaves. It is the haunt of thieves and law breakers, and the center of most of the lawlessness in our village. It will soon go down, however, before the march of western progress, and I am determined that so historic a spot shall not be entirely lost. I have a deep and lasting pride and interest in all that pertains to the early history of the operation which you, more than any man living, have brought to its present state of perfection. I wish to assure you of the kind feelings entertained for you by the ovariotomists of the United States, and for them express the wish that you may be spared yet many days of happiness and usefulness." It is always pleasant to see the work of British surgeons and of our associates gracefully acknowledged by foreigners, and especially by our American brethren, and our friends across the Atlantic are ever ready to return our appreciation of their work. We trust this British tribute to the memory of the "Father of Ovariotomy" may be accepted as some slight addition to agreeable acts of international fraternity. rabies can be suppressed by restrictive measures, including muzzling, registration, and licensing, with a sufficiently high dog tax, the destruction of stray dogs, and an efficient quarantine. Such measures would, if carried out for twelve months, rid this country of the disorder, and all fear of further attacks would be averted by maintaining the quarantine regulations. They can not, however, be left to local authorities, but only be satisfactorily carried out by the central government; while if adopted they would do away with the need for recourse to Pasteurian prophylaxis, and indeed also with the necessity of muzzling.-London Lancet. THE LEPER HOSPITAL AT HAVANA.-In the Nashville American of March 3d is a communication from Dr. Walter Dake, describing a visit lately made by him to a leper hospital at Havana, from which we print a brief extract. The hospital is the San Lazaro, located in the north western suburbs of Havana. "This hospital, at the time of our visit, had been in active existence somewhat over one hundred years, and during all that time had not lacked for inmates. It was founded by a wealthy Cuban who was himself a victim of the disease, and who, realizing terribly the great need for some such harbor of refuge for those so heavily afflicted, left all his fortune to establish and perpetually sustain this most necessary and worthy charity. THE SUPPRESSION OF RABIES.-Dr. G. Fleming contributes to the current issue of the Nineteenth Century an interesting and sensible plea for the introduction of measures for the suppression of rabies in this country, the case being stated in a manner which ought to convince the most skeptical. He begins with a brief historical survey of the prevalence of rabies in different parts of the world, and especially in these islands, quoting from old chronicles to show that it was not unknown in the eleventh century. The aims of the medieval physicians were directed to the cure of the disease, and not to its prevention; but experience in this present century has shown that whenever police measures have been enforced the ravages of rabies have been checked. Dr. Fleming asserts that the three reasons for the existence of rabies in this country are: (1) A defective sanitary organization for dealing with the contagious diseases of animals; (2) ignorance and apathy on the part of the public; and (3) a spurious sentiment of humanity with regard to dogs. He is very severe and caustic in his treatment of those who entertain the last-named views-the "cynophilists," as he terms them-and contrasts the treatment to which civilized and cultured humanity subjects the horse with the tenderness shown toward the dog, who must not even be suffered to bear the slight inconvenience of the muzzle. For, as he well shows, there is no doubt that given the lepers was ably supplied by several "The building was quadrangular in shape, with quite a large court, upon which opened the doors and windows of the little rooms wherein the lepers lived. In this court was a chapel or church in the form of a cross, with its main entrance upon the street outside the hospital. The body of the church was, therefore, accessible from without, and it was used to what seemed an amazing extent by those living near the hospital. The wings were railed off, being reached only from within, and in these the lepers worshiped, the men on one side and the women on the other. "The hospital is in charge of the Sisters of some order, whose names I did not learn, and the care and nursing of the inmates fell upon them. The medical and surgical attention. physicians who practiced in the city and whose term of office, compensation, etc., I did not investigate. That they did all that could be done, and that cheerfully and kindly, for those under their care, I can testify from what I saw, and from a conversation I had, through Dr. Burgess as translator, with the physician on duty at the time of our visit. He told me that he had tried many lines of treatment; had even amputated limbs where there seemed some dim hope that the disease was local; had tried dietetic and hygienic measures, baths, etc., with no favorable result. All that could be done, he said, was to make them as comfortable as possible, lessen their suffering, and let the disease proIceed with its dreadful work. "Within the courtyard, with his back toward us, sat a solitary man, who was not, as we soon discovered, either sick enough to be confined to his room nor well enough to be at mass.. As we came to him the doctor spoke and he turned toward us, and I see him now as I saw him then. He was apparently blind, his face was terribly disfigured, seamed with scars and swollen with tuberculous masses; his ears were twice the size of ordinary ears, the lobes pendulous, thickened, and heavy; his every feature as far removed as could be from the normal type of healthy manhood; his hands were disfigured and swollen, the fingers mostly gone, with only stumps to show where once they had been; the feet were worse, the right being entirely gone at the ankle, the left devoid of toes. "When we came down mass was over, and the court yard was filled with some seventy or eighty lepers. They crowded around us somewhat closer than we wished, but no one made âny attempt to touch us, for which we were most truly grateful. "The patients are supplied with tobacco, and, if they use it, are given opium. Most of the inmates are Chinamen and negroes, though many are of Spanish and Cuban descent. One of the smaller West India Islands produced the disease, and several of the cases were from it." Dr. Dake calls attention to this Cuban hospital as an excellent field for those who believe in Christian science to work in. "Here they would have a chance which could not but be a source of perpetual delight to them, and could they but succeed in curing the cases, which, of course they could do easily, judging from the literature of their faith, it would suffice to convert an unbelieving world." INFLUENZA A CONTAGIOUS DISEASE.-The Paris correspondent of the Therapeutic Gazette relates that, according to the official report of Dr. d'Hoste, of the transatlantic steamer “SaintGermain," the ship sailed on December 2, 1889, from St. Nazaire for Vera Cruz. All on board were well, influenza not having yet reached that part of France. On December 5th the steamer called at Santander for passengers, and there received among others a man coming from Madrid, where the epidemic was raging. The passenger, who was well when admitted, fell sick the next day, and soon the contagion spread on board, Dr. d'Hoste being the first to be influenzed. Out of four hundred and thirty-six passengers, one hundred and fifty-four were sick, with forty-seven of the crew and officers besides. Most of the cases were slight and a few dangerous, but no deaths resulted. From this unique observation the conclusion may clearly be drawn that influenza is a contagious disease, communicable not only through its complications and sequelae, but by itself before any sec ondary effects have developed. Such was the opinion expressed before the Academy of Medicine by Dr. Proust, a professor at the Faculty. Boston Medical and Surgical Journal. THE London Lancet, in commenting on a sensational article in the New Castle Daily Leader, says: The basis of the Leader's article purports to be "An Interview with a New Castle Physician," who claimed his own selfrighteousness in using a hand-wash of perchloride of mercury (1 in 1000), but expressed the opinion that the majority of medical men do not recognize the danger there is in attending confinements when they have been in connection with infectious cases. We think this an uncharitable and unjust accusation. It is by the efforts of medical men that the mortality of puerperal fever, even in lying-in hospitals, has been reduced to a minimum, and general practitioners are not only well acquainted with the means of personal disinfec tion, but have enormous inducements to disinfect in safe ways. There are doubtless careless or even unintelligent men in the profession, as in all other callings, but they are few and far between. The search for a perfect disinfectant is acute and constant, so much so that there is some risk that nurses and others may come to rely on it as to attach a superstitious importance to it, and to forget that, after all, pure air, perfect cleanliness, and personal hygiene in medical man, nurse, and patient are the indispensable conditions of safety. As Mermann will say, an antiseptic douche given with a dirty syringe and dirty fingers may be the very medium of infection. It will be remembered It will be remembered that in a sad series of fatalities last year in London in the hands of a midwife there was reason to believe that the poison originated in suppurative disease in her mouth. The question is one of principle and intelligence rather than detail, and we so far second our contemporary as to note his warning, and at the same time assure him that the profession was never more earnest than in the study of methods to secure the safety of lying-in women. TENTH INTERNATIONAL MEDICAL CONGRESS, TO BE HELD IN BERLIN, AUGUST 4TH TO 9TH. -The Committee of Organization of the Tenth International Medical Congress, R. Virchow, President; E. von Bergmann, E. Leyden, W. Waldeyer, Vice Presidents; O. Lassar, Secretary General, have appointed the undersigned members of an American Committee for the purpose of enlisting the sympathy and co-operation of the American profession. We are assured that the medical men of our country will receive a hearty welcome in Ber-lin. The Congress promises to prove of inestimable value in its educational results, and in securing the ties of international professional brotherhood. It is most important that the American profession should participate both in its labors and its fruits. Delegates of American Medical Societies and Institutions, and individual members of the profession, will be admitted on equal terms. The undersigned, therefore, beg to express their hope that a large number of the distinguished men of our country will appreciate both the honor conferred by this cordial invitation and the opportunity afforded us to fitly represent American medicine. The Congress will be held at Berlin, from the fourth to the ninth of August. The arrangements in regard to a few general meetings and the main scientific work, which is delegated to the sections, are the same as in former sessions. A medico-scientific exhibition, the programme of which was published a few weeks ago, is to form an ingredient part. It is to the latter that the Berlin Committee is very anxious that both the scientific and the secular press should be requested to give the greatest possible publicity. The office of the Secretary General is Karlstrasse, 19, N. W., Berlin, Germany. S. C. Busey, Washington, D. C., Wm. H. Draper, New York, R. H. Fitz, Boston, Mass., H. Hun, Albany, N. Y., A. Jacobi, New York, Wm. T. Lusk, New York, Wm. Osler, Boston, Mass., Wm. Pepper, Philadelphia, Pa., J. Peyre Porcher, Charleston, S. C., J. Stewart, Montreal, Can., Committee. The following from Dr. Jacobi explains itself: Editors American Practitioner and News: In a letter dated Berlin, Karlstrasse, 19, March-22d, Dr. Lassar, the Secretary-General of the Tenth International Congress, directs me to inform the Medical Profession of America that a programme of the Congress and other communications will be distributed two months before the meeting among those who shall have registered previously and received their tickets of membership. The latter can be obtained by sending application and five dollars to Dr. Bartel, Leipsigerstrasse, 75, Berlin, S. W. By so doing the members will save much crowding and time during the first days of the Congress. For the American Committee of the Tenth International Medical Congress. |